Pathophysiology:

Gallstones, which are concretions that develop in the biliary tract, typically in the gallbladder, are a symptom of cholelithiasis

(see the illustration below). When there are one or more gallstones in the common bile duct, it is known as choledocholithiasis (CBD).

The stage of the disease determines how to treat gallstones.

The most frequently cited supposition for the pathogenesis of chronic and acute cholecystitis is that small and medium-sized

gallstones that migrate from the gallbladder obstruct the cystic duct, or in the case of large gallstones, that they intermittently obstruct

the gallbladder neck. Clinical and histological human studies as well as experimental obstruction of the cystic duct in normal animals

do not, however, support this hypothesis. Although gallstones are occasionally seen in the cystic duct, it is unknown whether these

stones are actually preventing the passage of bile.

Due to the fact that cholelithiasis frequently does not create symptoms, patients may go undetected. The symptoms might range from

stomach pain or nausea to jaundice and biliary colic. Imaging methods are the most accurate way to diagnose gallbladder problems. To

aid differentiate the kind of gallbladder illness and/or detect related problems, laboratory results such as CBC, liver-function testing,

serum amylase, and lipase should be provided. Surgery is the most effective treatment for those with gallbladder disease. Patients

should be encouraged to adopt these healthy behaviors into their lifestyle in order to lower their risk of gallbladder diseases because

food, exercise, and nutrition all have an impact on gallbladder disease.

NCP:

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Subjective: Acute Pain related After 8 hours of Independent: After 8 hours of

“ I have an onset of to biological injury nursing nursing

abdominal Pain agent, as evidenced intervention, the Observe and Assists in intervention, the

radiating to back” by “ I have an onset patient will be able document location, differentiating patient verbalizes

as verbalized by the of abdominal Pain to verbalize feelings severity, and causes of pain, and feelings of relief

patient radiating to back” of relief and characteristics of provides and controls of

as verbalized by the controls of pain, pain. information about pain, and is able to

patient, autonomic and be able to disease progression demonstrate uses of

Objective: responses and, demonstrate uses of and resolution, relaxation

Temperature: 38.1 facial mask of pain. relaxation development of techniques.

BP: 150/70 techniques. complications, and

PR: 110 effectiveness of - Goal Met

RR: 22 interventions.

02 sat: 98
 Note the response Severe pain not

Pain scale of 8/10 to medication, and relieved by routine

Face grimace report to the measures may

physician if the indicate developing

Visible appearance pain is not being complications or a

of jaundice relieved. need for further

intervention.

Abdominal

tenderness in RUQ Promote bedrest, Bedrest in

allowing the patient low-Fowler’s

+ Blumberg Sign to assume a position reduces

position of comfort. intra-abdominal

pressure; however,

the patient will

naturally assume

the least painful

 position.

Use soft or cotton Reduces irritation

linens; lotion, oil and dryness of the

bath; cool or moist skin and itching

compresses as sensation.

indicated.

Encourage the use

Promotes rest, and
of relaxation
redirecting attention
techniques. Provide
may enhance
diversional
coping.
activities.
Dependent:

Administer Medications

medications as prescribed by

indicated: physicians to

alleviate pain, and

to treat causes and

onset of infections.

Interdependent: Gastroenterologist

Recommend to is the specialist

physician on call, as with expertise in

well as to the the disorders or

gastroenterologist. diseases in the

abdomen.
References:

Behar, J. (2013, February 24). Physiology and pathophysiology of the biliary tract: The gallbladder and sphincter of Oddi-A

Review. International Scholarly Research Notices. from https://www.hindawi.com/journals/isrn/2013/837630/

Lindenmeyer, C. C. (2023, February 14). Postcholecystectomy syndrome - hepatic and biliary disorders. MSD Manual

Professional Edition. Retrieved from

https://www.msdmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/postcholecystecto

my-syndrome

Douglas M Heuman, M. D. (2022, July 13). Gallstones (cholelithiasis). Practice Essentials, Background, Pathophysiology.

Retrieved from https://emedicine.medscape.com/article/175667-overview

Simore Afamefuna, P. D. C. P. C. of O. M. S. of P. S. (2013, March 20). Gallbladder disease: Pathophysiology, diagnosis, and

treatment. U.S. Pharmacist – The Leading Journal in Pharmacy. Retrieved from

https://www.uspharmacist.com/article/gallbladder-disease-pathophysiology-diagnosis-and-treatment

Lindenmeyer, C. C. (2023, February 14). Cholelithiasis - hepatic and biliary disorders. MSD Manual Professional Edition.

Retrieved from
https://www.msdmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/cholelithiasis#:~:te

xt=Pathophysiology%20of%20Cholelithiasis,use%20of%20total%20parenteral%20nutrition.